Corrective epicanthoplasty in patients with unnatural results of prior epicanthoplasty: rearrangement of the orbicularis oculi muscle above the medial canthal tendon.

BACKGROUND: Medial epicanthal fold operations are among the most frequent cosmetic procedures performed on Asians. However, in complicated patients with this procedure, as yet no effective method has been reported. We have therefore developed a modified epicanthoplasty method for correcting unnatural results in patients who have gone through prior epicanthoplasty.

METHODS: In this study, corrective epicanthoplasty was performed on 85 patients in the interval from January 2006 to December 2011. The age of these patients ranged from 18 to 67 years, with a mean age of 29.3 years. The follow-up period ranged from 13 months to 5 years, with a mean of 2.8 years. The 2 major complaints leading to the procedure were either presence of a prominent incisional scar with contracted tissue around the medial canthal area or relapse of the fold.

RESULTS: After the procedure, in each case, a contracted scar was released, and most patients seemed to be satisfied with the plasty. There was no case of definite relapse, hypertrophic scar, or lacrimal apparatus injury. Two patients experienced more overcorrection than anticipated. We reduced these patients' overcorrected epicanthal fold by repeating this procedure. A few patients complained about mild redness around their wounds, but after several months, most of them experienced improvement.

CONCLUSIONS: We have presented a method for correction of complicated epicanthoplasty, an area in which there have been no previously reported results. This modified method is simple in design, easy to perform, and effectively corrects medial epicanthoplasty.